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Decision-Making: What Science Tells Us About Approaching Ethical Dilemmas

Decision-Making: What Science Tells Us About Approaching Ethical Dilemmas
Lissa Power-deFur, PhD, CCC-SLP
November 20, 2020

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Editor's Note: This text is a transcript of the course, Decision-Making: What Science Tells Us About Approaching Ethical Dilemmas, presented by Lissa Power-deFur, PhD, CCC-SLP.

Learning Outcomes

After this course, participants will be able to: 

  1. Explain the science of decision-making.
  2. Identify the influence of biases, willful blindness and “group think” on response to ethical dilemmas.
  3. Identify strategies for mitigating negative influences on decision-making when approaching ethical dilemmas.


It's a delight to be speaking about one of my favorite topics of ethics and what science tells us about approaching ethical dilemmas. Let me start out by disclosing that I am not a neuroscientist but I have been fascinated by my colleagues in neuroscience who do research in this area. As I have talked to people over the years about ethical dilemmas, I'm always wondering why moving forward is difficult? Why is moving forward something that happens too quickly or too slowly?  So, I began to read about neuroscience and weaving it into my background in working on issues related to ethical issues.

Kendra Cherry writes a lot about science and psychology issues and I really appreciated this quote she had, "The human brain is powerful but subject to limitations." It's a good reminder to us that some of the challenges we face in ethical decision-making are not unique to us, it is part of the human condition. It's the way the human brain is created and wired which causes us to make decisions too quickly, to not fully consider everything, to take too long to make a decision, etc. There are many things that are going on in the human brain.  It is a great, great tool. It is what makes us human, but it also has some limitations.

We are constantly making judgments and decisions, consciously and unconsciously. I've read about the thousands of unconscious decisions that we make each day. Driving is a perfect example of that, cooking is another example.  We drive in a certain direction to work, we notice a stop sign, we notice a stoplight, we notice a car coming in from the left, and we aren't consciously thinking about that.  For those of you who are experts at sports and are comfortable playing a sport, there are many unconscious decisions you make as you play that sport.  Those of you who are runners or musicians, I think the same is true for you.

The conscious part of making decisions is when you're learning to play a musical instrument or learning to play a new sport. Actually, when you are learning anything that's new or encounter a situation such as, "Oh my goodness! There is a deer crossing the road. I need to be a little bit more mindful of what I'm doing. I can't just continue on autopilot down the road."

How well do we make these decisions? What can neuroscience tell us to improve our decision-making when we are facing an ethical dilemma? Why does human decision-making often violate logic? You've probably noticed this when looking back on something you did or perhaps you've noticed it about other people. "How did I do that? Why did I do that? Why did that person come to that conclusion?" What do we know about probability? Why is it that our decision-making doesn't line up with what the most probable answer might be? What are those features that influence our decision-making? I will talk about a few of these questions. 

Features of Neuroscience that Influences Decision-Making

This is, as I said, an executive summary of some of the features of neuroscience that influence our decision-making. I'm going to focus on four factors and what we can learn from science about how these factors influence our decision-making.

  • Limited cognitive capacity/cognitive strain - I imagine most of us have had an experience with this during the COVID crisis, as we are really strained by trying to do too much. I no longer have children at home but I totally appreciate the challenges that moms and dads have with children who are learning at home, while they are trying to do their job at home at the same time. Whether it is a job for pay, or whether it is a job managing the family at home. That's just one example of some of the cognitive capacity and cognitive strain we are all facing now. 
  • Personal predispositions, preferences, and biases - We often think of bias as a pretty negative term. But in actuality, it's a term that describes how we view the world, and I'll come back to that. 
  • Confidence in our own knowledge - We seem to have confidence in our own knowledge. That is not unique to speech-language pathologists, it's the human condition. 
  • Comfortable being comfortable - We, as humans, are pretty comfortable being comfortable. We are not too comfortable with negative information or with something we disagree with.

How Our Minds Make Decisions

Let's take a look at how our minds make decisions. "Thinking Fast and Slow" is a book written by Daniel Kahneman who was a winner of the Nobel Prize in Economics for the research he did on how we make decisions. I recommend this book. It's a comfortable read and much of what he says was captivating to me.  I rely a lot on Kahneman's work, which is really groundbreaking work.  The concepts of having two systems are highlighted in his research, System 1 is thinking fast and  System 2 is thinking slow. 

Systems 1 and 2

System 1 operates automatically and quickly. For example, driving down the road when there's nothing unusual going on. Going for a walk and we don't have to think about where we're going or how we're placing our feet. It involves little or no effort, no sense of voluntary control. We just do it with rapid, intuitive judgments. Those are examples of System 1 where we really don't need to stop and think. But sometimes we do make decisions from System 1.

System 2 is when we allocate attention to effortful mental activities. We are thinking about it and paying attention to it. We are involved with System 2 when we are concentrating, and thinking hard about something. It's when we make a judgment or when we are deliberating between things.

Continuing on with some additional examples of each system from Kahneman's work.

System 1

  • Sound localization - figuring out where sound is coming from
  • Automatic speech - "Hi, how are you?", "How's the weather?"
  • Detect emotions - We don't get to see people's smiles right now because we are wearing masks, but we can see the smiles in their eyes. We can detect emotion from someone's eyes.  
  • Automatic math and reading
  • Drive on an empty road
  • Understand simple speech
  • Sources for beliefs and choices in System 2

System 2

  • Attend to speech in noise - As SLPs, we know the cognitive skill it takes to focus on speech in a noisy situation.
  • Search memory for information - "What is that person's name? Why can't I think of it?" It's when we know we know the answer but we have to be purposeful when thinking about it. 
  • Complete physical activity that isn’t natural - An example would be taking a run through the woods instead of on a track.  Learning how to play the piano.  Learning how to do everything with your non-dominant arm/hand because your dominant arm is in a cast. 
  • Compare items for value - Comparing prices when grocery shopping or checking ingredients on grocery items.  
  • Complete taxes 
  • Check validity of position - checking the validity of someone's position on a subject, researching a person's position, and doing a comparison
  • Disrupted if attention is diverted - Our attention is diverted a lot these days. It is so easy to get pulled away. It is so easy for that to happen when you're trying to make a decision.

One of the things that Kahneman points out is System 1 is the source for our beliefs and choices in System 2. So, as we make our decisions in System 2, we are relying on all of these factors that are in System 1. For example, in our household, before my husband had heart surgery, we did not pay any attention to sodium in our diets.  My belief at that time was to focus on saturated fats. Now we know that sodium is a key issue so, it has become automatic for me to check for sodium.  I've evolved some of those automatic choices as I've gathered more information.

Let's try this out with a task.  Looking at Figure 1, read down each column and say whether the word is printed in lower or upper case.


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lissa power defur

Lissa Power-deFur, PhD, CCC-SLP

Lissa Power-deFur, PhD, CCC-SLP is Professor of Communication Sciences and Disorders and Interim Dean at Longwood University, where she has taught the course “Ethics and Professional Issues” since the program’s creation. She has served as a member of the ASHA Board of Ethics and on the ASHA Board of Directors as Vice President of Standards and Ethics in Speech-Language Pathology (2014-16). She has published and presented on various ethical topics.

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